Sunday, May 8, 2011

Big Pharma Behaving Badly (And Making Me Want to Vomit)

Sorry about the nauseatingly graphic nature of the title of this post, but the following info makes my head explode.

Pharmaceutical industry giant Merck Serano this week paid $44.3 million to settle a lawsuit alleging that the company paid kickbacks to MS neurologists for prescribing its blockbuster MS drug, Rebif (click here). The scam allegedly included hundreds of doctors, and seems to have been centered on the Consortium of Multiple Sclerosis Clinics (CMSC), a nonprofit corporation that is supposed to help educate patients. Among its other activities, the CMSC administers the quarterly NARCOMS surveys, designed to build an ever growing database on MS and its effects on patients, which are diligently filled out by thousands of multiple sclerosis patients, including, until now, yours truly.

The lawsuit was brought by a former Merck Serano employee turned whistleblower, who was fired by the company after expressing disbelief that such underhanded and blatant misdeeds were going on with the company’s full knowledge and participation. The entire lawsuit document is available online (click here), and to save you the trouble, the good stuff starts on page 6.

We're not talking nickels and dimes here, but huge chunks of cash, on the order of $25,000 a pop. The CMSC allegedly funneled over $500,000 to various doctors, effectively operating as a money-laundering outfit for Merck Serano, and the fact that the company settled for $44 million indicates this disgusting scam went far deeper than what is apparent in the legal document. Unfortunately, by settling the lawsuit, Merck Serano has effectively prevented all of the gory details from coming to light, as would've been the case if the suit had been brought to trial, and thus become public record. The settlement covers fraud charges regarding Medicare and Medicaid, but what of the patients that may have been steered into injecting themselves with a drug that might not have been their best choice by scoundrels in white lab coats more intent on stuffing their pockets than following the Hippocratic oath? Where is their justice?

Coming at a time when trust between neurologists and their patients has become frayed due to the CCSVI controversy, the revelations provided by the lawsuit and subsequent settlement are especially revolting. It is simply outrageous that a drug company can get away with paying physicians kickbacks for prescribing drugs with what amounts to a slap on the wrist. The terms of the settlement, $44.3 million might sound like a sizable sum, but considering that sales of Rebif exceed $1 billion a year, the penalty is miniscule. Additionally, this is most likely only a quick peek under a very big rock, and it is just a glimpse at goings-on that would shock and dismay the legions of desperate patients who are the real victims of these disgusting, dishonest, and deceitful practices.

Before being forced out of work due to disability, I was employed by one of the huge worldwide entertainment conglomerates, which included in its portfolio some of the biggest record labels on the planet. In the music industry, what Merck Serano is guilty of is referred to as "payola". Simply put, payola is the practice of paying disc jockeys, radio station program managers, and other "hit makers" to play and promote the songs of a music company's artists. Back in the 50s, payola brought down the careers of some of America's top DJs, and to this day people go to jail when found guilty of the crime.

Now, what's more harmful to society, a music company paying radio stations to play the latest Beyoncé single (I'm just pulling an example out of thin air here, not accusing Beyoncé or her record company of anything) or a drug company paying doctors to prescribe their products to desperately ill patients? The rancid stench of greed and avarice has infected many of our most important societal institutions. After reading the above allegations, can any patient truly trust that their doctor has no ulterior motive as he scribbles the name of some drug on his prescription pad, very often in an office whose walls and shelves are filled with posters and promotional products handed out like shiny trinkets by pharmaceutical company representatives? That swirling sound you hear is the ethics of an entire society going straight down the toilet.

The fact that this case was settled, and not brought to court, ensures that the names of most of the players will not be revealed. I'm tempted to reveal those named in the lawsuit here, but as a settlement was reached, and no verdict of guilt ever handed down, they remain simply accused, not convicted. My personal ethics therefore prevent me from slandering those who might not be guilty as charged, however unlikely that may be. That's not to say that you shouldn't click the link (here it is again), read the lawsuit, and find those names for yourself. In fact, I wholeheartedly encourage you to do so.

Every single doctor and medical professional who received any of these tainted funds, or participated in distributing them, should be named, shamed, stripped of their licenses, and thrown in jail. They're a disgrace, each a pustule on the ass of humanity, and deserve nothing more than humiliation and degradation. Unfortunately, thanks to the niceties of a system that too often protects those in positions of power at the expense of the regular folks who rely on them, the scoundrels involved will remain anonymous, free to enjoy the fruits of their despicable actions. Despite our high-minded ideals of justice for all, far too often there is justice for none.

As for those involved in this medical and legal debacle, and the many other similar cons we will likely never hear about, may their eyes fall out. Bastards.

36 comments:

The credibility of all MS Neuro's that have conflict of interest with Pharma should be questioned. This only exposes what so many CCSVI advocates have suspected from the beginning. It is these very same doctors from the CMSC who have been the experts advising (I mean fear mongering) to our government officials in Canada. It is the very same Neuro's at the CMSC who run the MS Clinics and sit on the MS Society's medical and research advisory committees. It is the very same MS Neuro's that continually speak about how dangerous and unsafe CCSVI testing and treatment is in the media and slant the studies in a negative way to the uneducated public and MS sufferer who have placed their trust and their health in the hands of these self serving, biased Neurologists. This needs to be exposed and every doctor that has received pharmaceutical kickbacks needs to be investigated.

Marc, to question the honesty in prescriptions of CRABS makes me sad. I don't want to believe that greed rules, but reading what Merck Serano has done just confirms there are SOB:s out there. How many SOB:s are there? How wide spread is this?

Why don't you invest time in posting the names of the Greedy Neurologist, Doctors, Lobbyists, Representatives of big Pharma, and Politicians who are supposed elected, so we can use our Democratic Right and FIGHT BACK!! The corruption we see all around us need to be stopped. We need people like JOE WILSON. (Watch the movie FAIR GAME.) If big business can put "yes" families, such Bush (the Slush Fund) Family Dick (the slick) Cheney, Carl (the hitman) Rove and Scooter (the loser) Libby and... the list is endless. As this is Mother's Day, I personally want to put a "pox" on all of their GENES!

OMG! I'm sure this is going on North of the border too. Wish they would of pushed for the jury trial and not taken the settlement. It would have been a huge shake up. Mean while our provincial health minister says they cannot approve CCSVI trials or treatment here until it is proven safe and ethical. Who has Canadian politicians in there pocket?? Those drug companies should all be investigated. No one is looking for a cause let alone a cure, no money in that.CCSVI is the only hope. It has given me back a life I never thought I could have again.Thanks Marc for helping us open our eyes.

I'm not in the least surprised by this story. In 1996, I was a patient at the MS Clinic at McMaster University Medical Centre in Hamilton, Ontario. I was told that I should be on the new wonder drug - Rebif - and that it would slow or stop my MS progression. When the doctor told me it was for the relapsing-remitting form of MS, I said that didn't sound like me as I had never experienced remission; only a slow and steady deterioration. He literally waved his hand in front of my face and snapped "you're relapsing-remitting!" Well. OK then. You're the expert.

I injected myself with Rebif for 4 years (at $2000.00 a month) and saw no cessation of my worsening symptoms however I started to suspect that it could be the cause of my almost constant depression. Although the Dr. kept prescribing it (he said it had nothing to do with my depression), I stopped using it and my depression miraculously lifted. That's when I decided to see a new neurologist. My new neuro said that I was secondary progressive and had never been relapsing remitting so Rebif should never have been prescribed. He was also shocked that I had been on it for 4 years. In his opinion, it may do some good in the first 2 years (IF you're RR) but he believes it's actually harmful after that time.

Do you think there may have been some financial incentive behind my first neuro's behaviour? Yeah? Me too.

BTW - I was treated for CCSVI in May of 2010 and it's been like a miracle. I no longer wear an AFO and my once crushing fatigue has disappeared. No neurologist. No drugs.

You should also take note, Kamikake, the Teacher's Union Fund donated the largest amount of money to both political parties the Republican and Democrat. So go figure. Or maybe not. Because this education group is behind the push, in the public schools, to turn out so many bad teachers, who turn out the many Walmart Associates (that word "associate" -work for little and be grateful to your superiors- reminds me of the acronym "BUM" -Buy-U-Moron; and McDonald Associates -trained to obey and tell-tale; and all of the other low paying service jobs that pay little, demand loyalty -especially when accidents occur. And sadly, these are the people who do NOT vote!

Kazmo,Its these type of situations that make me easily lose faith in finding a cure. Another cink in ethics armor of our medical society. The only chance we have is if they offer a "reward" to cure mns. Otherwise company's like Merck will continue to gross 2.7 billion a year with this snake oil we are injecting. I would rather have a b-sting my finger every day than to pay these bastards another red cent. Especially this prick at the Rocky Mountain MS center who puts out all these Ms publications. I would like these assholes to have to climb into my diabled body for just one fucking day and see how many kickbacks they take. They'd be too tired to do anything.ps. has anyone ever flown you gratas to Honolulu?www.thegreekfromdetroit.com

I agree that settling is a disappointment because I would have loved to have seen all the names come out. And if Merck Serano was doing this you can be sure most, if not all, of the major drug companies do it too. And probably not just for MS drugs. The profits are so high and there is competition so they'll do whatever gives them an edge, ethics be damned. It's truly sickening but I'm not shocked or surprised. Thank God for whistleblowers who do the right thing.

I read about this in the WSJ. What was glaringly absent was the condemnation of the doctors behaviour. If they were ethical and turned down the bribes. Merck's plan would not have been able to suceed. I'd like to hear from honest neurologists condemming Merck's actions and laying out guidelines for patients to protect themselves from becoming a victim. Because, really, you have to be your own advocate, as we all know. I also was irritated that all the money goes to lawyers and the government. Becaause they were shooting themselves up with unnecessary medications. What aboput the patients? And what about the taxpayers who are supporting the programs that have been cheated?

I am happy to say I am not in any danger of being duped, although I did try Rebif for 8 months. But quit at my dr's reccommmendation.

Instead of being disgusted and pissed off, we somehow need to stand (or sit) up and pull a Howard Beale and yell out our windows, "I'M MAD AS HELL AND I'M NOT GOING TO TAKE THIS ANYMORE!" Writing our congressmen hasn't worked, talking to our neuros hasn't worked, taking these drugs haven't worked. We need an Egyptian revolution.

It would have been nice had the poor souls that were prescribed the Rebif by their crooked neuros, got the settlement. Once again MSers screwed. I think your title is quite appropriate.I took Rebif for 1 month and quit, it made me sick as hell.Luckily, I'm smart enough to not trust my drs. But the people who blindly follow what there Drs tell them because they believe they have their best interests at heart are the ones that I feel sorry for.

This is precisely why it's hard to trust doctors. As an ex-Pharma marketing employee, I know far too much to blindly buy-in to whatever Rx a doctor recommends. Their enthusiastic endorsement of some expensive drug therapy usually indicates ulterior motives. Sadly, drugs are formulated, researched and promoted based on potential consumer markets and profits ($$$,$$$,$$$,$$$), not need or outcomes. That's why we endure erectile dysfunction ads during dinnertime while willing MSers get to be human pin cushions. How can greedy Pharma execs and neurologists sleep at night? DISGUSTING!!!!

I saw a neuro (briefly) who told me "Rebif or nothing." I told him that I had already tried Rebif in the past, and I progressed wildly. He just looked at me and said again, "Rebif or nothing - I don't prescribe any of the other drugs."

My current neuro does a lot of clinical trials, but he will prescribe any of the CRAB etc. drugs - whichever one he feels is the most effective. In fact, I really wanted to get into a clinical trial when I first starting seeing him, but he wouldn't let me. He said that for someone in my situation (progressing rapidly), he wanted to see me on a definite treatment, rather than putting me in a trial and hoping I wasn't put on a placebo. As much as I wanted the chance to try a new drug, I respect that he was looking out for my well-being more than being concerned with "filling seats" in his trial.

He's a good doc, but I know there are plenty of them out there who are just in it for the money and could care less about the well-being of their patients.

Thanks for highlighting this news event. I have so many thoughts that it is difficult to begin to articulate them. I believe that kickbacks for prescribing specific medications are wrong. Inaccurate billing and/or reporting of accurate "best prices" to government programs is stupid. Or rather, it is stupid that the gov't doesn't have the legal authority to negotiate those best prices to begin with. Thanks to the original Medicare Part D wording.

With that said, the allegations are just that, allegations...ones which are unsubstantiated (and will stay that way since the case didn't go to trial). I can't speak to what the named doctor did or did not "demand" or request in money or items or books or whatever.

I just know that my own neuro (founder and former President of the Foundation of the CMSC) and my MS nurse (prominent leader in MS nursing field) have made good use of pharma-provided funds in their practice. In an article dated in 2005, they explain and describe support programs which they had developed for the MS center. After the program was established and demonstrated to be effective, my MS team requested an educational grant from a pharma company so that they could continue to provide the extra outside-of-the-exam-room services. I attended these monthly programs as a newly-diagnosed patient and can say that it didn't matter didly-skwat who provided the grant monies.

Although money and influence can be abused, I wouldn't want to see the resource dry up for the actual GOOD programs which are being developed and provided for patients.

Oh dear, I could go around in circles on this one. I'll stop there. One last thing, my blog was started to critically discuss pharma-related issues. I was pissed off! Gotta say, that I'm so much more relaxed now that the same neuro mentioned above doesn't want me on any "official" MS drugs and that I don't have to fight for access to them any longer. But that doesn't mean that they are off the hook for more critical attention. http://bit.ly/jItJH6

Hey, I'll be coming to NYC for a brief visit/meeting in June. We must get together.

Hi, this is eye opening and scary. Sometimes it really seems like this mess continues because docs really don't know how to fix us. My doc really pushed Copaxone. It made me suspicious but at the end of the day I had literally been on all the other meds. I was getting worse and had nothing to lose. In other words I was forced in a corner. Nicole

Funny that my first neuro put me on Rebif right away, and that I reacted to it poorly and had more lesions. I don't trust any of them. Makes you wonder is CCSVI tests and treatment aren't covered under insurance b/c the insurance companies are paid off by the drug companies!

Well Marc, the good news is my First Neuro (Dr. C, you know him)had me choose my first DMD (of course, like an idiot (retrospect) I chose Rebif). Being PPMS, of course nothing would have helped. When I later stopped he was in complete agreement. I really think he is one of the good guys out there. There are some.kicker

Thanks for this excellent overview of the Serrano issue - I have also created a Facebook Note on the Serano issue which I update periodically. I was a former corporate auditor and anti-corruption adviser (Iraq), so my point is that the Dept of Justice should have gone for criminal prosecutions, but I talked to one of their attorneys who said it was decided to go the Civil suit route, which means just fines. See my Facebook "CCSVIUSA" page note at https://www.facebook.com/note.php?note_id=160462850683248

FYI...The Consortium of MS Clinics is holding their annual conference in Montreal on June 1 to 4th. All the very caring and respected MS Neuro's from the MS Clinics along with the very caring and respected MS Societies will all be under one roof. I would think this would be an appropriate venue and perfect timing to thank them for all they have done and all the sacrificies they have made for MS sufferers. The media should be notified to witness this love in event. I am confident these very compassionate doctors will be presenting all the latest and greatest new drug therapies that will be available in no time and will provide not only hope but improved quality of life for all their patients just like Rebif did.

Here's the email to Joan:"Your Facebook page contains libelous statements concerning the Consortium of Multiple Sclerosis Centers. It also contains a link to “freepdfhosting.com%2F543bcc781b.pdf&h=f2fcd,” which itself contains a United States District Court complaint THAT WAS FILED UNDER SEAL.

That complaint includes libelous and false statements. The party who allegedly made the statements has denied them.

This firm has been retained by the Consortium of Multiple Sclerosis Centers to defend its rights and to seek damages."

Time for everyone to post the above cited link to their Facebook page. We wouldn't want Joan and Marc to be the only ones this firm is chasing after.

@Anonymous, is that really all you have to say? Spell the name right? Wow, thanks for the help, there, very very helpful, when Serono has been paying doctors to screw over their patients, and give them drugs they don't need,that might actually be harmful to their health, we really really need to spell the name correctly, so we know exactly who we are speaking about..thanks again

I find it ironic that you can talk about big pharmaceutical companies acting badly when you yourself are acting badly. Twice I have posted about my ccsvi experience, and because it was not positive you have not posted it. It has not been the answer for me and it will not be the answer for others. This site in part talked me into going for this procedure. This cost me well over $20,000 and did nothing. You are pushing this procedure and not telling the full story of its failures. I know that this will not be published as you are biased and selling this procedure just as a pharmaceutical company was selling rebif. I really thought you were different.

Big red-sorry that you did not receive relief from your procedure, but I take exception to your assertion that in any way I've pushed the CCSVI treatment procedure on this website. I've always tried to present the facts about CCSVI, and neither persuade or dissuade anyone from pursuing treatment. As a matter of fact, I've often used the phrase, "waiting is definitely not a bad choice".

As for the comments you say were not posted, the only comments that don't make it onto the blog are from spammers. I have posted every other comment that's been made, either positive or negative. I welcome all thought on all topics. It is possible that you may have tried to comment on an older post, and that the e-mail notification of your comment somehow made it into my spam file, in which case I would not have seen it. I welcome you to e-mail me at WheelchairKamikaze@Google.com to tell me which post you commented on, because I'd love to know if your comments fell through the cracks so that I could try to correct the situation in the future…

Thank you for another insightful intelligent post.Makes me happy that I've avoided all those drugs for the 26 years that I have lived with MS.One of the main reasons I read your posts is that you are very unbiased and honest.You have become my main source for info on MS.Keep up the great work.Thank you so much Mark. Sincerely, Scott F. from way upstate NY.

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Regretfully, due to the high volume of e-mail received and the realities of living with progressive MS, I'll no longer be able to respond to all e-mails sent. I do read each note, and will do my best to answer as many messages as I can.

About Me

I'm Marc, a 53-year-old male, living in New York City with my lovely and wonderful wife Karen. Diagnosed with Primary Progressive Multiple Sclerosis in March of 2003, I now require a wheelchair to get around the city. I like to drive the wheelchair at full speed, thus the moniker "Wheelchair Kamikaze". I've managed to rig a camera to my chair, so I'm able to take videos and still photos from the unique vantage point of a wheelchair, which I intend to post here.
Before getting sick, I was the Director of DVD Production for one of the major international music companies. Yes, I was once a member of the Evil Empire...
Prior to my enlistment in the Evil Empire, I worked as a video producer and editor.
I grew up in New York City, and spent the 1980s in Boston (college and postcollege rock 'n roll craziness). During the 1990s, I lived in South Florida, until I woke up one morning and realized I was living in South Florida, came to my senses, and moved back to New York.
I hope you like my blog...